No availability of HRT patches

[Egghead68]

Hi - my foray into HRT will be short-lived, it seems (3 weeks in total) due to lack of availability of HRT treatments in my area.

I was on Evorel Conti, which can't be obtained now (I had 6 patches which my pharmacist said were the last ones). I have asked my GP if they will prescribe an alternative but they have not got back to me and my patch runs out on Tuesday. In any case, it seems there are low/no stocks of most/all forms here due to people having to switch.

Anyone else had this problem and got any suggestions?

Thank you in advance!

Has anyone switched to the cream instead of patches? There doesn’t appear to be a shortage of oestrogen cream/gel?

Rosie there was lots of media coverage of this issue a couple of weeks ago.

Ok the latest updates say Evorel is expected to be out of stock by October and then not available until mid 2020!
So I have a generic oestrogen patch prescription which means I don’t need Evorel necessarily. But this issue is already causing shortages of the others. Why this pause in manufacturing?

@teta I have just a few mins ago posted alink to the BMS news on availability and 'reasons'

No one seems to know the truth. There IS an issue with the adhesive for some patches- this is well known.

The other types- no one is sure. It's poss stock piling by instruction from the Dept for Health as a precaution for Brexit so there will be SOME available and pharmacies are only being allowed a quota at the moment.

Has anyone seen Evorel 75mg available? I'm a surgical menopause person. The thought of crashing into menopause instantly, given I've cardiac issues, is pretty terrifying tbh.

Me too Ohyoubadbadkitten

oh no - been on Zumenon tablets for the past month (first month) and it says there is a shortage of supplies - my pharmacy did say though as it's not been very long I could change to another brand if required.

ugh. Sorry that you are in this boat as well Katy. This really sucks.

I'd be happy to try estrogen gel if needed. What would be the equivalent dose to a 75mg patch - it would be good to go armed with info to my gp.

This is the list from the BMS. If you need to swap, your dr will tell you the appropriate dose for the swap.

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British Menopause Society further update on HRT supply shortages
23 August 2019
In response to the ongoing HRT shortages, the British Menopause Society has produced this further update on the current availability of HRT products. This provides guidance to BMS members and clinical practitioners who may be experiencing difficulties with HRT supplies.

There continues to be availability issues with many HRT products, either related to manufacturing shortages or supply issues. The BMS has been informed that these are temporary shortages which pharmaceutical companies and their suppliers are addressing.

In the meantime, prescribers can continue to consider equivalent preparations that provide a similar dose to that which their patient is using. If an exact match is not possible, prescribers can seek guidance available on the practical prescribing chart on the BMS website and Menopause Matters website, to clarify equivalent doses.

Consideration could also be given to prescribing estrogen and progestogen separately to make the closest match or find a suitable alternative.

Different brands for the same medication may vary in appearance or excipients. However, they would provide equivalent amounts of hormones when used in similar doses.

BMS members can post prescribing queries on the BMS forum if any clarifications are required.

The information on stock availability and supplies below was obtained from the pharmaceutical companies producing these products.

Besins Healthcare (UK) HRT products
No shortage of supplies of their HRT products:

Oestrogel systemic oestrogen gel.
Utrogestan (micronised progesterone) 100 mg in continuous combined regimen and 200 mg in sequential regimens.

Orion HRT products
Sandrena 0.5 mg sachet Available.
Sandrena 1.0 mg sachet Shortage of supplies until mid September 2019.
Indivina 1mg oestradiol + 2.5mg medroxyprogesterone acetate Available.
Indivina 1mg oestradiol + 5mg medroxyprogesterone acetate Available.
Indivina 2mg oestradiol + 5mg medroxyprogesterone acetate Shortage of supplies until end of August 2019.

Tridestra 2mg oestradiol + 20mg medroxyprogesterone acetate Available but there is currently 2 week delay in delivery of orders.

If difficulty obtaining supplies, the company has suggested contacting their customer care on 01635520300 to guide them to the wholesale suppliers.

Evorel patches (Janssen)
Janssen have provided the following update on their Evorel patch products:

Janssen has issued the following update regarding their Evorel patch supplies:

There is an interruption of supply for Evorel®, Evorel® Sequi and Evorel® Conti that will result in shortages to patients. The product range will stockout at the end of October 2019. The company anticipates that pharmacies will be out of stock until mid-2020.

For further questions or additional information, please contact: Janssen Medical Information Department: email: [email protected], telephone: 0800 731 8450 or 01494 567 444.

Estradot patches (Novartis pharmaceuticals):
Available. No supply shortages.

If difficulty obtaining supplies, the company has suggested contacting their customer care to guide them to the wholesale suppliers, on 08457 419 442; E-mail [email protected]. Frimley Business Park, Frimley, Camberley, Surrey, GU16 7SR.

Merck Sharp & Dohme Limited
Livial (2.5 mg Tibolone) Available.

Mylan HRT products
Supply information as of 21st August 2019:

Elleste Solo™ 1mg oestradiol. Available.
Elleste Solo™ 2mg oestradiol. Available.
Elleste Duet™ 1mg oestradiol + 1mg norethisterone acetate. Available.
Elleste Duet™ 2mg oestradiol + 1mg norethisterone acetate. Available.
Elleste Duet™ Conti 2mg oestradiol + 1mg norethisterone. Shortage of supplies.
Femoston® 1mg oestradiol + 10mg dydrogesterone. Shortage of supplies.
Femoston® 2mg oestradiol + 10mg dydrogesterone. Available.
Femoston® conti 1mg oestradiol + 5mg dydrogesterone. Available.
Femoston® conti low dose 0.5mg 0estradiol + 2.5mg dydrogesterone. Available.
Zumenon® 1mg oestradiol and 2mg oestradiol. Shortage of supplies.
Elleste Solo™ MX patches 40mcg transdermal oestradiol. Available.
Elleste Solo™ MX patches 80mcg transdermal oestradiol. Available.

Mylan’s manufacturing partner continues to experience interruptions in the production of certain strengths of Elleste™, their Hormone Replacement Therapy (HRT). They have informed us that they will continue to provide updates on timing for resolution, as they receive them; to the British Menopause Society as well as to healthcare professionals via their sales team. Mylan understands the challenges this situation poses to women and is working closely with their manufacturing partner to expedite deliveries when possible.

Mylan has a dedicated website for healthcare professionals, which has LIVE information about current supply of their HRT. The overview of stock availability page can be accessed on: mywayhub.co.uk/en-gb/range

It is important to note that Mylan HRT stock can only be obtained through AAH, Alliance and Phoenix

If you have difficulty obtaining supplies please contact Mylan Customer Service on: [email protected]

Estraderm MX patches (further update pending)
Estraderm MX 50 patches pack of 24. Available.
Estraderm MX 75 patches pack of 8. Available.
Estraderm MX 100 patches. Available.
Estraderm MX 50 patches pack of 8. Shortage of supplies.

Novo Nordisk HRT products
No shortage of supplies of any of their HRT products:

Kliovance 1mg oestradiol + 0.5mg norethisterone acetate.
Kliofem 2mg oestradiol + 1mg norethisterone acetate.
Novofem 1 mg oestradiol + 1 mg norethisterone acetate.
Trisequens 2mg/2mg/1mg oestradiol + 1mg norethisterone acetate.
Vagifem 10mcg topical vaginal oestrogen.

Has anyone got patches from the online supplier at the top of this board?

Yes and also from Boots after much phoning round (didn’t intend to get 2 packs - I don’t want to stockpile and cause others problems).

However, unless it is my imagination, the patches seem to be different. The previous lot I had (my first) stuck really well (in fact too well, and left lots of black adhesive marks). These new ones crinkle and fall off after 1-2 days.

Article in the Daily Fail ( sorry !) today saying that Novartis do not manufacture enough of the Estradot patches to supply demand. Also gives various reasons for this issue such as a shortage of some of the patch constituents in China.I'm still not sure what to believe .

So there weren't enough Estradot and everyone moved on to Evorel and somehow the manufacturer can't restock until the middle of next year?

There was a short interview on Radio 4 Today this morning at around 7.20am. They spoke to the chair of the BMS and the issue is also headlining on BBC News online.

More info in each of the above.

@Teta there is no supply issues with Estradot according to BMS list.

No there isn't but it's running out everywhere because of the lack of Evorel patches . Evorel is the market leader and Novartis can only supply 10% of the demand as they don't manufacture enough. I'm not sure whether they're restricting supply as well?
Mylan patches are in stock at the moment online.
Dodgy story from the makers of Evorel re. running out due to high demand this year .Why would that stop manufacture until mid next year?

One theory doing the rounds is that Johnson and Johnson who own Janssen producers of Evorel are withholding supplies to the UK because if/when we go to WTO rules at the end of October tariffs will mean that the NHS will have to pay substantially more for their products thus making them a shed load more money, it's quite weird that the rest of the world who use their products aren't experiencing shortages.

Messaged you @autumncrow

This is a farce!

Heard the piece @JinglingHellsBells mentioned on the radio this morning. The part I liked was that at last there is some degree of pressure on the manufacturers to be clearer about what the issue is, though whether we will ever know remains to be seen.

Just back from Lloyds pharmacy where the pharmacist rang two wholesalers no evorel 50, 75 or 100, Conti and sequi for foreseeable future and because of demand no estradot or Estraderm in stock either. She also checked oestrogel and the wholesaler only had 2 in stock because GPS are switching patch prescriptions to gel.

One theory doing the rounds is that Johnson and Johnson who own Janssen producers of Evorel are withholding supplies to the UK because if/when we go to WTO rules at the end of October tariffs will mean that the NHS will have to pay substantially more for their products thus making them a shed load more money, it's quite weird that the rest of the world who use their products aren't experiencing shortages

@rosie39forever

Eh? If tariffs are imposed it's a tax and goes to the government not the manufacturer.

@KatyMac, thanks for PM and yes to helping each other out, and I'll be in touch shortly.

I'm another surgical menopause patient like @OhYouBadBadKitten and I'm very angry and disappointed with the government on this, and tbh I think GPs should have been a lot more on the ball from a few weeks ago for their priority patients e.g. those in early and surgical menopause and in particular those women with heart issues, risk of osteoporosis, those with menopause related depression & anxiety, etc.

Actually I'm disgusted by it all.

However I'm very appreciative of all the helpful posters on here. Thank you so much.

@Autumncrow If you need only estrogen after surgery, there are a number of options . Read a Tweet today from meno specialist saying she had been able to provide all her patients with some form of suitable HRT.

My pharmacist says he can get my patches. I will see what happens.
If he discovers he can't, I am going to try and get them in France.
Will report back.